Ohio § 3923.55

§ 3923.55.

(A) As used in this section and section 3923.56 of the Revised Code : (1) “ Child health supervision services ” means periodic review of a child's physical and emotional status performed by a

physician, by a health care professional under the supervision of a physician, or,

in the case of hearing screening, by an individual acting in accordance with section 3701.505 of the Revised Code . (2) “ Periodic review ” means a review performed in accordance with the recommendations of the American

academy of pediatrics and includes a history, complete physical examination, developmental

assessment, anticipatory guidance, appropriate immunizations, and laboratory tests. (3) “ Physician ” means a person authorized under Chapter 4731. of the Revised Code to practice medicine

and surgery or osteopathic medicine and surgery. (B) Notwithstanding section 3901.71 of the Revised Code , each policy of individual or group sickness and accident insurance delivered, issued

for delivery, or renewed in this state on or after the effective date of this amendment,

that provides coverage for family members of the insured shall provide, with respect

to that coverage, that any benefits applicable for children shall include benefits

for child health supervision services from the moment of birth until age nine. (C) A policy that provides the benefits described in division (B) of this section may

limit the benefits to cover only the expenses of child health supervision services

that are performed by one physician or by a health care professional under the supervision

of one physician during the course of any one visit. (D) Copayments and deductibles shall be reasonable and shall not be a barrier to the

necessary utilization of child health supervision services by covered persons. (E) Benefits for child health supervision services that are provided to a child during

the period from birth to age one shall not exceed a maximum limit of five hundred

dollars, including benefits for the hearing screening required by the program established

under section 3701.504 of the Revised Code .  The benefits for the hearing screening shall not exceed a maximum limit of seventy-five

dollars.  Benefits for child health supervision services that are provided to a child during

any year thereafter shall not exceed a maximum limit of one hundred fifty dollars

per year. (F) This section does not apply to any policy that provides coverage for specific diseases

or accidents only, or to any hospital indemnity, medicare supplement, or other policy

that offers only supplemental benefits.